Doctors in one of the world’s top mesothelioma hotspots say they have found an oral drug combination that appears to slow the progression of mesothelioma in patients who may have exhausted their treatment options.

The study comes from cancer researchers at the Antalya Education and Research Hospital in Antalya, Turkey who tested a combination of oral cyclophosphamide and etoposide – a combination they refer to as ‘EE’. More than half (54.5%) of the mesothelioma patients who received EE experienced stable disease, meaning their mesothelioma tumors stopped growing for a period of time. Four of the 22 patients had an even better result – their mesothelioma tumors actually shrunk. In the remaining 35.9% of patients on EE, mesothelioma continued to progress.

Cyclophosphamide is a chemotherapy drug most often used as part of a combination of drugs to treat lymphoma, leukemia, and some forms of brain cancer. It is believed to work, in part, by eliminating certain immunosuppressive T-cells. Etoposide is an anti-cancer drug derived from a toxin found in the American Mayapple plant. The Turkish researchers say that, together, these two drugs may offer a treatment path for patients who have already had standard chemotherapy and are not eligible for surgery.

Mesothelioma patients who are not candidates for surgery are usually treated with a combination of pemetrexed and cisplatin. There are currently no approved second-line therapies for mesothelioma patients who do not respond to standard treatment. Although mesothelioma tumors started growing again within a median of 7.7 months on the EE treatment, the overall survival for patients in the Turkish study was 28.1 months – significantly higher than the typical life expectancy for a newly diagnosed mesothelioma patient, which is about one year.

Turkey has an unusually high per capita mesothelioma rate in part because of the prevalence of the asbestos-like mineral, erionite.

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